Citation Nr: 21068905 Decision Date: 11/15/21 Archive Date: 11/15/21 DOCKET NO. 14-32 843 DATE: November 15, 2021 REMANDED Entitlement to a rating in excess of 10 percent for lipoma, status post resection with residual scar, upper left back (hereinafter "left upper back lipoma") is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1979 to June 1985. In April 2020, the Board issued a decision that denied a rating in excess of 10 percent for the Veteran's left upper back lipoma. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In May 2021, the Court issued an Order that vacated the Board's April 2020 decision and remanded the matter on appeal for adjudication consistent with the instructions outlined in a May 2021 Joint Motion for Remand (JMR) by the parties. Entitlement to a rating in excess of 10 percent for left upper back lipoma is remanded. In the May 2020 JMR, the parties agreed that remand was warranted for the Board to address whether the Veteran's scar was both painful and unstable and whether a separate rating was warranted for neuropathic/neuralgic pain based on the January 2019 VA examiner's finding that the Veteran's burning and stinging pain into the left upper arm and left leg was likely neuropathic/neuralgic pain caused by the lipoma removal. After a thorough review of the Veteran's claims file, the Board finds that the current evidence of record is insufficient to address the May 2020 JMR requests and to adequately adjudicate the Veteran's claim. In pertinent part, the January 2019 VA examiner indicated the Veteran's left upper back scar was not unstable. However, the examiner did not reconcile this finding with the Veteran's July 2014 statement that his scar was unstable. Moreover, while the January 2019 VA examiner indicated the Veteran had neurological pain of the left upper and lower extremities associated with his left upper back scar, further development is required to fully address the etiology and severity of the Veteran's neurological manifestations. As such, remand is warranted for additional VA examinations consistent with the directives herein. The Board also notes that the Veteran has indicated he received treatment for this condition in October 2019. See October 2019 Statement in Support of Claim. However, the most recent VA treatment records are from November 2018. Accordingly, additional development is requested to obtain the Veteran's updated VA treatment records. The matter is REMANDED for the following actions: 1. With the Veteran's assistance, obtain any outstanding records of pertinent medical treatment from VA or private health care providers, to include updated VA treatment records dated from November 2018. All reasonable attempts to obtain such records should be made and documented. If VA attempts to obtain any outstanding records which are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). 2. Following the record development above, schedule the Veteran for a VA examination with an appropriate examiner to ascertain the nature and current severity of his service-connected left upper back lipoma. The claims folder and a copy of this remand must be made available to the examiner for review in conjunction with the examination. All indicated testing must be conducted and all pertinent symptomatology and findings must be reported in detail. a) The examiner must measure the accurate size of the Veteran's left upper back scar and indicate whether such scar is painful, unstable, deep or superficial, or linear or non-linear. The examiner is also asked to determine whether there is any disabling effect(s) caused by the Veteran's service-connected scar. b) The examiner must question the Veteran regarding his July 2014 statement that his left upper back scar is unstable and determine whether this disability was considered "unstable" for VA purposes. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 3. Following the record development above, schedule the Veteran for a VA examination with an appropriate examiner to ascertain the etiology and severity of the Veteran's neurological pain of the left upper and lower extremities. The claims folder and a copy of this remand must be made available to the examiner for review in conjunction with the examination. All indicated testing must be conducted and all pertinent symptomatology and findings must be reported in detail. a) The examiner should provide diagnoses as to whether the Veteran has any neurological disorders, to include a nerve condition of the left upper and lower extremities. In rendering these diagnoses, the examiner must consider specifically the findings from the January 2019 VA examiner indicating that the Veteran has neuropathic pain. b) The examiner should opine as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that any diagnosed neurological disorder was caused or aggravated by his service-connected left upper back lipoma, status post resection with residual scar. Aggravation in this context is defined as any increase in disability. In rendering this opinion, the examiner must consider/discuss the January 2019 VA examination report that indicates the Veteran's burning and stinging pain into the left upper arm and left leg was likely neuropathic or neuralgic pain caused by the lipoma removal. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Metzner, Paul The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.